The Royal College of Physicians (RCP) has submitted its response to the NHS England medical training review.
Drawing on evidence from its ‘next gen’ national survey of over 1,000 resident doctors, as well as extensive engagement with physicians across the UK, the RCP has highlighted some major challenges – and is proposing a bold, clinically led blueprint for the reform of medical training.
The RCP will publish its full response to every consultation question in the coming weeks as part of a next gen campaign series of blog articles. A more detailed analysis of the full set of survey results is underway by resident doctors from the RCP next gen oversight group and will be launched later this summer. Headline findings so far include:
- Dissatisfaction and burnout: just 44% of respondents to the next gen survey were satisfied with their clinical training, with many citing lack of supervision, excessive rota gaps, and limited access to outpatient and procedural training.
- Unmet demand for flexibility: nearly half (47%) of respondents to the next gen survey want to work less than full time, but current structures do not adequately support this or recognise prior clinical experience gained in non-training roles.
- Failure to prepare for the future: training does not consistently equip doctors with the leadership, digital or risk-management skills required for modern consultant roles.
- Generalist training reform needed: the balance between generalist and specialist training needs a new vision, with doctors learning a broader set of skills that will help them to lead multiprofessional teams in planned specialist and community-based care.
RCP president Dr Mumtaz Patel said:
‘The NHS cannot deliver safe, high-quality care without a well-trained medical workforce. But too many of today’s resident doctors are working in environments that undermine their learning, wellbeing and professional development.
‘I am delighted that over 1,000 resident doctors responded to our next gen survey – we will listen to them, and act on what they have told us. It’s time to rethink medical training for a new era of healthcare – one that is community-based, digitally enabled and rooted in prevention of ill-health.’
The RCP response sets out clear recommendations, including:
- a new approach to workforce planning that links training posts to local health need
- protected time and funding for educators, with clear national standards for training environments
- the piloting of college-accredited ‘stay local’ training pathways, that allow residents to complete most, if not all, of their training in a smaller geographical region, especially in areas with high health inequalities or where the NHS struggles to recruit
- modular, competency-based progression that values skills gained inside and outside formal training pathways
- greater investment in community-based training placements, digital health education, and support for resident doctors returning from time out of programme
- targeted efforts to reduce differential attainment and ensure equity for international medical graduates and doctors from minority ethnic backgrounds.
RCP Resident Doctor Committee co-chairs, Dr Anthony Martinelli and Dr Catherine Rowan added:
‘Too many resident doctors are left feeling underprepared to become the consultant physicians of the future. One in four (26%) respondents to the next gen survey felt that their current role was not preparing them to submit a competitive application for the next stage in their career pathway – and a further 48% said it was only partially preparing them. Something has gone badly wrong with medical training if this is the case.
‘We are calling on the medical training review to address bottlenecks in training progression at key transition points, tackle burnout and improve resident doctor wellbeing, and explore how we can better balance generalist and specialist training opportunities. Our next gen campaign will continue to advocate for resident doctors with the ultimate aim of improving access to high quality patient care.’
Find out more about the RCP next generation campaign at www.rcp.ac.uk/nextgen.
- The RCP response to the call for evidence of the NHS England national medical training review is informed by the RCP next generation oversight group, Resident Doctor Committee (RDC), Student Foundation Doctor Network (SFDN), New Consultants Committee (NCC) and RCP Council. It was submitted on 20 May 2025.
- This response includes evidence from membership snapshot surveys, the 2023 census of UK consultant physicians and the national snapshot survey of resident doctors (the ‘next gen’ survey) as well as existing policy positions, including the RCP manifesto for medicine.
- It also includes feedback from RCP regional trust and health board visit focus groups, RCP next gen oversight group meetings/discussion papers, RDC and SFDN meetings/discussion papers, and debates at RCP Council.
- The national snapshot survey of resident doctors (the ‘next gen’ survey) was open between 9 April - 5 May 2025. The link was shared widely through membership newsletters, on social media and via RCP networks, committees and advisory groups. Of 1684 respondents, 1010 were working as a resident doctor in a clinical setting in the UK, with most working in the NHS (96.3%) and mainly based in a hospital (95.3%). 36.2% were working as specialty registrars, 24% as IMT doctors, 18.2% as foundation doctors and 16.9% as LEDs. 56.6% said they were a member of a royal college or faculty.